Symptoms & diagnosis

Symptoms & diagnosis

Symptoms & diagnosis

How do I know if I'm hard of hearing?

 

Common symptoms experienced by patients with hearing loss are the following:

 

  • They ask the interlocutor to repeat words or they misinterpret his words
  • Those around them complain that they turn up the TV volume
  • They have difficulty hearing everyday sounds such as the doorbell, telephone, alarm clock, birds chirping, etc.
  • They have been flagged for speaking loudly
  • They do not clarify the words of a sentence, as a result of which they cannot communicate properly
  • They have difficulty communicating in groups larger than two people
  • They have tinnitus (buzzing) or ringing in their ears
  • They have difficulty identifying the direction a sound is coming from

The above are just some indications and each case may differ. However, if you or someone in your environment is faced with one or more of the above-mentioned symptoms, we recommend that you immediately undergo an audiological evaluation.

Hearing loss diagnosis


The hearing test is carried out with various tests that are selected based on suitability criteria. The most common test is the tone audiogram, which is usually accompanied by a tympanogram. Young children or infants who are unable to cooperate with the audiogram can undergo otoacoustic emissions and evoked potentials (ABR) hearing tests.


 

Degree of Hearing Loss

 

An audiogram is a graph that shows the results of a pure tone hearing test. It shows how strong they must be the sounds at each frequency for the examinee to hear. The audiogram shows its type, degree and configuration hearing loss.


Hearing loss is classified as mild, moderate, severe or very severe (residual) and can affect one or both ears of the patient. More specifically:

  • Mild hearing loss: 21 dB – 39 dB
  • Moderate hearing loss: 40 dB – 69 dB
  • Severe hearing loss: 70 dB – 89 dB
  • Very severe hearing loss: more than 90 dB

     
Symptoms & diagnosis

Audiological tests

Acoustically Evoked Brainstem Potentials

What are acoustic evoked potentials?

 

Auditory Brainstem Evoked Potentials, better known as ABR (from the term Auditory Brainstem Response) are the response of the central auditory system to external auditory stimuli. Their measurement is an objective examination of the integrity and functionality of the neural auditory pathway from the auditory nerve to the brainstem.

 

What is the use of the measurement of acoustic evoked potentials?

 

As we said, ABRs assess the neural signal transduction for auditory stimuli in an objective way, that is, the examinee does not have to do anything during the examination. Therefore, they are particularly useful in cases where conventional methods are impractical to use (eg in infants). They are also useful in cases where conventional methods of hearing assessment have not provided a clear conclusion and further investigation is needed.

 

How is the examination of auditory evoked potentials done?


The examination of the auditory evoked potentials is a simple and painless examination and, in fact, because the examinee does not need to do anything during it, it can be performed even when the examinee is asleep. The steps of the examination are as follows:

 

  1.  1. The examinee sits comfortably in a quiet area.
  2.  2. Electrodes that record brain activity are placed at various strategic points on the head glued to the skin.
  3.  3. We put headphones on the examinee from where we give various auditory stimuli, usually "clicks" or clear tones.
  4.  4. The brain's response to these stimuli is recorded through the electrodes.
  5.  5. The results are evaluated in order to draw conclusions about the functionality of the auditory pathway.
Speech Audiometry

What is speech audiometry?

 

Speech audiometry is a special test used to assess a person's ability to hear and understand speech. Unlike a traditional audiogram, which measures loudness thresholds for hearing pure tones (the softest sounds a person can hear at different frequencies), speech audiometry assesses how well someone can recognize and understand spoken words in different levels of intensity.


How is a speech audiometry test done?

 

During a speech audiometry test, the examinee hears various words through speakers or headphones and is then asked to repeat them. These words or sentences are spoken at different volume levels, as well as with different noise levels, simulating realistic listening conditions.


Why do we do speech audiometry?

 

The main advantage of speech audiometry over the conventional audiogram is that it examines hearing ability from a side much closer to realistic listening conditions and better assesses the real impact of hearing loss on the individual, since it examines how communication is affected. Therefore, it is also particularly useful for the correct adjustment of hearing aids, since having speech audiometry as a guide, we can, by measuring speech recognition abilities with and without hearing aid, evaluate the settings of the hearing aids and adjust them accordingly. In this way, the effectiveness of the headset is maximized in its most basic purpose, in restoring communication.

Tympanogram

What is a tympanogram?

 

The tympanogram is an objective examination of the ear that checks the function of the middle ear and therefore whether the sound is transferred smoothly from the outside to the inner ear. Specifically, it measures how much the tympanic membrane's motility changes as a function of the air pressure applied to it.

 

What conclusions do we draw from a tympanogram?

 

Through this measurement several conclusions can be drawn about the condition of the middle ear such as the presence of otosclerosis or some other bone disorder, the presence of fluid (e.g. after an otitis media), or whether the Eustachian tube is functioning normally . All this information can be very useful to identify the location and type of damage, and therefore show us the corresponding treatment method.

 

How do we do a tympanogram?

 

A tympanogram is a simple, short and painless test. It is performed with a special instrument, the tympanograph, which has a tube at the end. This tube is placed inside the ear and in just a few seconds we get our results.

Aural broadcasts

What are otoacoustic emissions?

 

Otoacoustic emissions (OAEs) are very low-intensity sounds produced by the hearing organ in the inner ear, the cochlea. They are generally divided into two large categories, as they can be produced either spontaneously (Spontaneous Otoacoustic Emissions or SOAEs) or in response to some sound stimulus - evoked (Evoked Otoacoustic Emissions or EOAEs). The important thing is that the otoacoustic emissions can be measured and through them we can draw conclusions about the functioning of the cochlea.

 

What is the use of measuring otoacoustic emissions?

 

As we said, otoacoustic emissions are divided into spontaneous (SOAEs) and evoked (EOAEs). Challengers are divided into 3 subcategories:
 • Transient-Evoked Otoacoustic Emissions or TEOAEs
 • Stimulus-Frequency Otoacoustic Emissions or SFOAEs
 • Distortion-Product Otoacoustic Emissions or DPOAEs

 

The most useful categories of these in clinical practice are TEOAEs and DPOAEs. The whole logic of the measurement for detecting hearing loss is based on the fact that the otoacoustic emissions are very low intensity (typically <20dB SPL) and at the same time at frequencies where the threshold of hearing is greater than 20-30 dB (i.e. above the threshold of hearing and above) no OAEs are produced. So, if at a certain frequency we do not have OAEs production, we know that at that frequency there is hearing loss. The measurement of otoacoustic emissions is a very simple, painless, non-invasive technique since the examination is done by placing a special small "tube"-detector in the ear that will show the results in just a few minutes. At the same time, it does not require the patient to do anything during the measurement, which makes it an ideal method for objective assessment of hearing in infants and in general in people who refuse or cannot cooperate with a conventional hearing measurement, such as an audiogram. . Finally, the OAEs test can also show us if there is something blocking the auditory pathway in the outer or middle ear, since if there is such a thing (e.g. excess alveolus, fluid collection, etc.) the OAEs will not be able to reach the external auditory canal and be detected.